Provider Demographics
NPI:1861949281
Name:STATZ, HILDA (PSYD, LPC-S)
Entity type:Individual
Prefix:
First Name:HILDA
Middle Name:
Last Name:STATZ
Suffix:
Gender:F
Credentials:PSYD, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 CANYON CREEK
Mailing Address - Street 2:
Mailing Address - City:CANYON LAKE
Mailing Address - State:TX
Mailing Address - Zip Code:78133-4170
Mailing Address - Country:US
Mailing Address - Phone:915-422-3664
Mailing Address - Fax:830-688-4900
Practice Address - Street 1:106 CANYON CRK
Practice Address - Street 2:
Practice Address - City:CANYON LAKE
Practice Address - State:TX
Practice Address - Zip Code:78133-4170
Practice Address - Country:US
Practice Address - Phone:915-422-3664
Practice Address - Fax:830-688-4900
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional